Healthcare Provider Details

I. General information

NPI: 1629834163
Provider Name (Legal Business Name): WORKSTAR OCCUPATIONAL HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4366 KUKUI GROVE ST STE 207
LIHUE HI
96766-2006
US

IV. Provider business mailing address

PO BOX 31000
HONOLULU HI
96849-5812
US

V. Phone/Fax

Practice location:
  • Phone: 808-676-5331
  • Fax: 808-671-2931
Mailing address:
  • Phone: 808-676-5331
  • Fax: 808-671-2931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAYLIN WINCHESTER
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 808-676-5331